Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere2021; 49(5); 310-319; doi: 10.1055/a-1584-9150

[Evaluation of clinical examination parameters and a scoring system in equine colic as well as the assessment of their prognostic value].

Büttner, J
·
Brehm, W
·
Gittel, C

Abstract: In horses, colic is associated with relatively high mortality rates. Identification of parameters associated with poor outcome may aid in providing a more accurate prognosis. This study aimed to assess the early prognostic value towards survival of the horse based on parameters of the clinical examination. Methods: In a retrospective study (2013-2017), results of the clinical examination of horses with colic were analyzed. Obtained parameters were categorized from physiologic up to different pathophysiologic manifestations. The risk of death was calculated as odds ratios in comparison to normal values of these parameters. Individual score points were obtained and related to the respective outcome. Cut-off values for prognosis and treatment were calculated to distinguish between outcome and treatment group. Results: A total of 492 colic horses were analyzed, presenting 433 survivors (88 %). Overall, medical treatment was selected in 346 (70.3 %) horses (with 96 % survivors) and surgical treatment (laparotomy) was performed in 146 (29.7 %) horses (69.2 % survivors). An increased likelihood of the outcome "death" was found in horses aged over 20 years (OR = 5.498, p 6 hours duration (OR = 3.590, p = 0.035) and, also, for breeds of draft horses (OR = 8.364, p < 0.0005). Horses with significant increases in heart and respiratory rates (OR = 24.294, p < 0.0005 and OR = 20.375, p 90 mg/dl: OR = 26.390, p 6 Stunden (OR = 3,590, p = 0,035), einem Alter von > 20 Jahren (OR = 5,498, p < 0,0005) und einer Zugehörigkeit zur Rassegruppe Kaltblut (OR = 8,364, p < 0,0005). Häufiger verstarben auch Patienten mit einer deutlich erhöhten Herz- bzw. Atemfrequenz (OR = 24,294, p < 0,0005 bzw. OR = 20,375, p 90 mg/dl; OR = 26,390, p < 0,0005). Mit dem Punktesystem ließ sich nicht eindeutig ein signifikanter Zusammenhang zwischen höherer Gesamtpunktzahl und schlechterer Prognose nachweisen. Unassigned: Parameter der klinischen Untersuchung sowie anamnestische Angaben können einen Hinweis für die Prognose des vorgestellten Kolikpatienten liefern. Eine eindeutige Klassifizierung hinsichtlich Überleben oder Therapieoption ist jedoch nicht möglich. Eine gründliche Patientenevaluation ist notwendig, um die weitere Therapie auszuwählen und die Prognose bewerten zu können.

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Publication Date: 2021-10-19 PubMed ID: 34666367DOI: 10.1055/a-1584-9150Google Scholar: Lookup

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Journal Article

Summary

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The research discusses a study conducted to evaluate certain clinical parameters in horses with colic and assess their prognostic value for determining outcomes. A scoring system was used, though it failed to establish a significant connection between high scores and poorer prognosis. The parameters and patient history were found to hold some potential for predicting patient outcome, but the study did not provide a definitive categorization method.

Methods

The study was performed in a retrospective manner, analyzing clinical examination results of horses with colic between 2013-2017.
The various parameters were grouped into physiological and pathophysiological stages.
The risk of death was calculated using odds ratios, comparing the risk with normal parameter values to find the likelihood of the disease resulting in death.
The total points achieved by adding individual parameter values were related to the eventual outcome of the disease.
For forecasting prognosis and deciding treatment methods, cut-off values were calculated.

Results

The study assessed 492 cases of colic in horses, with 88% or 433 horses surviving.
Almost 70.3% of the horses underwent medical treatment, with a 96% survival rate. The rest (29.7%) received surgical treatment (laparotomy), experiencing a 69.2% survival rate.
Horses older than 20 years, with colic symptoms of over 6 hours’ duration, and draft horse breeds had a higher odds ratio indicating a higher risk of death from colic.
Horses with significantly elevated heart and respiratory rates and increased blood lactate concentrations were more likely to succumb to the disease.
The scoring system did not show any significant correlation between higher scores and a poorer prognosis.

Conclusions

The study concluded that while the clinical examination parameters and the history of the patient might give some indication of the potential outcome, there was no clear distinction between survival and treatment options based on the examined parameters.
The findings emphasise the importance of a thorough patient investigation to decide the course of treatment and to assess prognosis accurately.

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APA

Büttner J, Brehm W, Gittel C. (2021). [Evaluation of clinical examination parameters and a scoring system in equine colic as well as the assessment of their prognostic value]. Tierarztl Prax Ausg G Grosstiere Nutztiere, 49(5), 310-319. https://doi.org/10.1055/a-1584-9150

Publication

Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere

ISSN: 2567-5834

NlmUniqueID: 9715779

Country: Germany

Language: ger

Volume: 49

Issue: 5

Pages: 310-319

Researcher Affiliations

Büttner, Jasmin

Klinik für Pferde, Veterinärmedizinische Fakultät der Universität Leipzig.

Brehm, Walter

Klinik für Pferde, Veterinärmedizinische Fakultät der Universität Leipzig.

Gittel, Claudia

Klinik für Pferde, Veterinärmedizinische Fakultät der Universität Leipzig.
The Queen's Veterinary School Hospital, Department für Veterinärmedizin, Universität Cambridge.